Editorial

Response to the growing dementia burden must be faster

According to 2017 estimates from WHO, nearly to be covered in future ADI reports, and currently too few
50 million people are living with dementia, and by 2030 data are available to assess progress towards the targets
the number is expected to reach 82 million. As this for support for carers, research and innovation, and
figure grows, so too will the need for support and care diagnosis, treatment, care, and support. For the action

Alzheimer’s Disease International

for people with dementia, which is projected to cost area of information systems, the target is for 97 countries
US$ 2 trillion globally by 2030. The need to prepare for to collect a core set of dementia data by 2025, ideally
and try to prevent some of this personal and financial through the WHO Global Dementia Observatory (GDO),
burden has received increasing attention, most notably a new platform for countries to share data on dementia
with adoption by the World Health Assembly last year of indicators across all seven action areas. 21 countries
the WHO global action plan on dementia. One year on, a have contributed to the pilot phase of the GDO, but For the 2017 WHO estimates of
the burden of dementia see
report from Alzheimer’s Disease International (ADI), the even among these countries data are incomplete. If the http://www.who.int/mental_
global federation of Alzheimer’s disease associations, ambitious WHO global action plan on dementia is to be health/neurology/dementia/
infographic_dementia/en/
shows that not enough progress has been made. successful, more member states need to start collecting
For the WHO global action plan
Governments need to make dementia a higher priority and sharing their data through this platform. on dementia see http://www.
and must take action quickly to prevent the burden of Several initiatives are underway to accelerate progress who.int/mental_health/
neurology/dementia/action_
dementia from becoming overwhelming. and support member states that are willing to take action. plan_2017_2025/en/
The overall goal of the WHO global action plan On June 1, 2018, WHO published a practical guide to For the ADI report see https://
www.alz.co.uk/adi/pdf/from-
on dementia is to “improve the lives of people with preparing a dementia plan. WHO has also developed an plan-to-impact-2018.pdf
dementia, their carers and families, while decreasing the online support programme for carers, is working with the For the Global Dementia
impact of dementia on them as well as on communities 21 pilot countries and others to collect more data through Observatory see http://www.
who.int/mental_health/
and countries”. The plan outlines targets to be met the GDO, and is preparing evidence-based guidelines neurology/dementia/Global_
by 2025 in seven action areas: dementia as a public on risk factors for cognitive decline and dementia (due Observatory/en/
For Towards a dementia plan:
health priority; dementia awareness and friendliness; in late 2018) and a toolkit to help communities, cities,
a WHO guide see http://www.
risk reduction; diagnosis, treatment, care, and support; and countries become more dementia friendly (due in who.int/mental_health/
neurology/dementia/policy_
support for carers; information systems; and research and early 2019). Broader initiatives also have the potential guidance/en/
innovation. On May 23, 2018, ADI published From Plan to to help. For example, the targets for risk reduction align For the programme for carers
Impact, a report looking at progress so far. ADI intends to with those of the WHO global action plan for prevention see https://www.
isupportfordementia.org/en
publish a new edition of the report each May, and the first of non-communicable diseases (NCDs), although the
For more on the risk factor
installment is largely not encouraging. WHO Independent High-Level Commission on NCDs guidelines see http://www.who.
The first target of the WHO global action plan on recently described progress by countries as “not on track” int/mental_health/neurology/
dementia/risk_reduction_gdg_
dementia is that 146 WHO member states should have and “uneven at best”. The potential for risk reduction meeting/en/
developed or updated their national dementia policies, must not be ignored, as it has been estimated that For the report of the WHO
Independent High-Level
strategies, plans, or frameworks (collectively known as interventions to increase exercise and social engagement, Commission on NCDs see
dementia plans) by 2025. Developing a dementia plan is reduce smoking, and manage hearing loss, depression, The Lancet Commissions
Lancet 2018, published online
arguably the most important first step, as it should lead diabetes, and obesity have the potential to prevent or June 1. http://dx.doi.
to progress in the other action areas, but only 27 WHO delay about a third of cases of dementia. org/10.1016/S0140-
6736(18)31258-3
member states have such plans so far, and only one (Chile) It could be seen as early days: the WHO global action
For more on the potential for
has developed a plan in the past year. ADI estimates that plan on dementia was adopted only a year ago, the GDO is risk reduction see The Lancet
15 new plans must be put in place each year for the target even newer, and WHO is still preparing documents to help Commissions Lancet 2017;
390: 2673–734
to be met. Worryingly, less than half of the existing plans governments do their part to meet the targets. But so
have received funding for their implementation. far, too few governments are showing willingness to act.
Less information is available on progress in the other 1 year of the 8-year plan period has already passed, and
areas of the WHO global action plan on dementia, in part 2025 is not so far away. Governments must stop being
because reporting of data is insufficient. Risk reduction complacent if they are to mitigate the growing personal
and dementia awareness and friendliness are expected and national costs of dementia. ■ The Lancet Neurology

www.thelancet.com/neurology Vol 17 August 2018 651